It is remarkable, when you come to think of it, how rarely novelists portray nice people. Or, indeed, happy marriages. Well, they do exist, and in this novel Sylvia Brownrigg does them justice. We have Peter Braverman, a teacher of Russian, and his wife Mira, a therapist around whom the damaged and distraught wheel like starlings. Peter and Mira are childless, in their sixties; and they get on fine.

That's about it for the happy people, though. Mira's patients are, on the whole, a dispiriting bunch; the woman who had a horribly late miscarriage; two others who are trying very hard indeed to get pregnant; and one nicknamed the Bigot, well-observed in all his weakness and menace, who taunts Mira because she is Serbian. (Making the central character a Serb and setting the novel in 1998-99, as Kosovo is about to be bombed by Nato, is one of Brownrigg's quiet audacities, an instance of her willingness to address complexities.)

"The Delivery Room" is Peter's sobriquet for Mira's office or consultation room, where the aggrieved middle classes pour out their distress; but there are a number of associations lurking within the title: not only is this a book about deliverance from grief, but also about birth, and the wish to give it; and death, too, another kind of delivery. I won't be spoiling the novel for you by saying that Peter contracts lymphoma; one of Brownrigg's achievements is to be able to look at death and dying squarely. It's a nice touch, and one not too worked over, that Peter is a fan of Samuel Beckett.

It is a carefully paced novel; early on, I wondered whether it was, in a good way, boring or not. It wasn't: I simply hadn't quite adjusted myself to its measured rhythms. It has to be measured: there are lots of Themes, and a novelist needs a light and cautious touch not to drum up their significance. This is, after all, a novel about life as it is lived. It has to maintain maximum plausibility for it to work. It is entirely gimmick-free, studiedly familiar, alive and faithful to the inner workings of its cast.

The contrast between what goes on on the surface and what goes on underneath is something else that Brownrigg is keen to explore. Brownrigg, an American, has lived for some time in England, but wrote the book in America, and the distance has helped rather than hindered: setting it in Camden Town, among the grey, buttoned-up English, makes complete sense. Emotional costiveness, the paradoxical impulse to deny the expression of that which should most be expressed, is a great challenge for a novelist. Mira, listening to English people evading the issues during their therapy sessions, and then collapsing in grief, is herself bound by the rules of her profession from either giving them the sound advice or hugs that they might really need. (It is interesting that just about the only false-sounding note in the novel is an American woman's speech - it sounds a little too deliberately "American". But as Brownrigg cannot have got that wrong, it must be more that she has got the English voice exactly right.)

The formal dance of the counselling session has never been better portrayed, and when Mira does that and-how-does-that-make-you-feel thing that therapists do, you come to understand that this is as much a way of parrying her own feelings as it is a way of allowing her patients to work towards some insight into their own troubles. ("The challenge then was to allow the patient to find the line for him- or herself. The psychotherapist ... was a little like those clever, subtle sheepdogs they showed on the television here." A nice historical detail, incidentally.)

So, in its unassuming way, this is actually a very ambitious work. It's buttressed by its attentiveness. The telling adjective is always popping up. A small example: one foreign character is struck by England's "bossy streets" - and, when you come to think of it, she's right, England's streets are awfully bossy compared to other nations'. I can't think of them in any other way now. When a description gets under the skin like that, then you can be fairly confident that the writer is on the money.